Who cares about AIDS?

• Position: International AIDS Trust - Interview

Last November, Worldwatch staff researcher Radhika Sarin talked with former U.S. AIDS Czar Sandra Thurman, non' head of the International AIDS Trust, about the difficulties caused by widespread cultural taboos and a backward-looking or distracted Bush administration.

WORLD WATCH: With the UN's global fund [against AIDS] so under-funded by governments, who is going to step up and fill the funding gap?

Sandra Thurman: The vast majority--maybe even 99 percent--of the $10 billion needed annually to mount an effective campaign for both prevention and treatment is going to have to come from developed nations. Even the Gates Foundation, which is the largest foundation donating to these kinds of efforts at the moment, is still only giving $100 million here and $100 million there. It helps, but we need a lot more than that.

So it's going to have to be governments that give the majority of the money. Currently, of the $10 billion that we need a year, governments are only contributing about $2 billion. So, there is a huge gap.

WW: Is the current U.S. administration making it difficult?

ST: It's difficult. But they haven't been bad to work with. Secretary [Tommy] Thompson [of the U.S. Department of Health and Human Services (HHS)] is very interested in expanding HHS's involvement in global AIDS issues.... So there is some commitment in the administration, but this is not a priority for them at the moment. They have some folks who are fairly conservative [about] what constitutes national security and what doesn't. While I have a tremendous respect for many of them, quite frankly they are looking at this 21st-century challenge with 20th-century vision.

WW: What about the recent work of the National Intelligence Council addressing AIDS as a security issue, and the growing number of security people in the past two years talking about the impact of AIDS on stability--is all that going to help?

ST: It will make a huge difference. A lot of people who don't really give a damn about what the people in the health community say will hear about AIDS from their friends in the security community. I mean, these are separate cultures.

When I was at the White House, we had our first National Intelligence Council Report that talked about AIDS as a security and stability issue in 1999. And that was tremendously helpful to us in advocating in Congress and elsewhere, and beginning the conversation about what, in our modern-day world, constitutes security and stability. It's not the old Cold War model.

It's a very interesting time, with people really starting to understand that AIDS is not just a health issue, but a fundamental security issue, a fundamental development issue, and a fundamental economic issue in the countries hardest hit. So we have to have a multidisciplinary approach. We have never struggled with a problem quite like this before--a problem that requires a shift in paradigms and priorities across so many different communities. In the women's community, in education, anywhere you go, something is going to...